Dr. Georges Benjamin has served as Executive Director of the American Public Health Association (APHA) since 2002. Although he initially pursued a career in medicine in order to learn enough biology to become a gene splicer, he quickly fell in love with the field of medicine. He attended the University of Illinois College of Medicine on a military scholarship and specialized in Adult Medicine. Dr. Benjamin joined the army upon graduation, fully planning a career as a practicing physician. However, an unexpected opportunity to run an army medical center launched his lengthy career in health management. Dr. Benjamin worked in city and state government, and led organizations through a number of health crises, before assuming the top position at the APHA. Dr. Benjamin believes he has been able to enjoy such a varied career because he chose an education that prepared him to do a variety of things. Truly, his career trajectory is a testament to the power of seizing unexpected opportunities!

1999 – 2002: Secretary of the Maryland Department of Health and Mental Hygiene

2002 – Present: Executive Director of the American Public Health Association

Are there some points in your career that you are particularly proud of?

In every job you find something you think is really neat. When I was in D.C., the HIV/AIDS epidemic was a major problem. We spent a significant amount of time and effort addressing AIDS in D.C. We really focused a laser on HIV/AIDS, in particular among substance abusers and pregnant women, because we were beginning to see the impact of AIDS on women, especially in the black community. In the early 1990s we responded to the shifting epidemiology and built on our Maternal and Child Health work to address HIV/AIDS.

My years as Maryland Health Secretary were likewise transformative. We had outbreaks in new diseases like West Nile virus and the Anthrax letters. Tragically, we had a severe drought and we had a tornado! When I was there, in terms of the health statistics, everything that was up, was up, and everything that was down, was down. I had an amazing staff. Maryland has a combined health department, which means that everything was in the health department, except Occupational Health and Safety and the Insurance Commissioner. This meant I could push a lot of people into the same room, I had all the levers. Very few Health Officers have that capacity! The 9/11 tragedy brought different types of partnerships together that were new and interesting. Even though it was a tragedy it created a lot of partnerships and friendships.

What about any challenges?

D.C. was tough! The economy was in a recession, and we had a tough time balancing the budget. Many say that D.C. is recession proof, but it’s not. As Maryland Health Secretary, our Medicaid program grew while we simultaneously moved the financing mechanism from volume-based (e.g., fee-for-service) to value based (e.g., capitation, paying for quality, etc.). We were successful but it was tough to change the mindset of the people outside government. We had to push people to accept that we are in the business for health, not managing resources.

When it comes to public health, being where you are now, what matters to you and why?

At APHA, we believe it’s important to be effective. There are a lot of issues on the table so trying to pick the ones that are most important and that you can have the most impact on is most important to us. It is important to be heard on the right issue where we can uniquely make a difference, versus shouting at the rain, and being against or for a lot of important things. If you are not for and against the right things then you are not going to be effective.

I hate to make you pick a problem, but in the landscape, what do you think is still a persistent public health problem that concerns you?

Right now, the issue is maintaining funding for public health. Public health is getting whacked! All over the place, funds are getting dramatically cut. There is a general view that our government spends more than we can afford. I understand that concern, and we want to be fiscally conservative as well. On the other hand, there are some things you have to spend money for and other things you don’t need to spend money for. Public health is one of the things where we ought to be spending more and more. It’s a major challenge to push for enhanced resources to move our nation towards prevention and wellness, at a time when you have to balance spending for emergencies and other things. It’s hard to try and make that argument amongst people who cringe when you ask for another dollar.

So in your ideal world, what is the solution to this problem?

We have to do a better job of defining public health’s “value add” to the public. Public health always talks about how our best work is done when nothing happens, and that’s true. But when nothing happens you don’t get funded! There are no incentives to put resources behind something that didn’t occur. If you forget the fact that it didn’t occur because there were resources there in the first place, then you get in a circular argument. What we need to do is put a face to it. I think we need to find the resources to measure public opinion on a regular basis, so that we can craft public opinion. We do this by getting our message out to people so that they can understand the trade offs and the value of public health.

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